N-ACETYLCYSTEINE IN COMBINATION WITH NITROGLYCERIN AND STREPTOKINASE FOR THE TREATMENT OF EVOLVING ACUTE MYOCARDIAL-INFARCTION - SAFETY AND BIOCHEMICAL EFFECTS
N-ACETYLCYSTEINE IN COMBINATION WITH NITROGLYCERIN AND STREPTOKINASE FOR THE TREATMENT OF EVOLVING ACUTE MYOCARDIAL-INFARCTION - SAFETY AND BIOCHEMICAL EFFECTS
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DOI：
10.1161/01.cir.92.10.2855
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发表时间：
1995-11-15
期刊：
影响因子：
37.8
通讯作者：
HOROWITZ, JD
中科院分区：
文献类型：
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作者：
ARSTALL, MA;YANG, JF;HOROWITZ, JD
背景N-乙酰半胱氨酸（NAC）已被证明可以增强硝酸甘油（NTG）的作用，并具有抗氧化活性。这是第一个研究，以评估NAC在治疗进展性急性心肌梗死（AMI）的安全性和有效性。方法和结果AMI患者接受15 g NAC（n=20）或没有NAC（n=7），联合静脉NTG和链激酶。测定外周静脉血浆丙二醛（MDA）、还原型（GSH）和氧化型（GSSG）谷胱甘肽浓度以及再灌注率（使用连续ST段分析）。在第2 - 5天进行心导管插入术。未发生重大不良事件。与未接受NAC治疗的患者相比，接受NAC治疗的患者发生的氧化应激较少（4小时时GSH/GSSG比值为44+/-25 vs 19+/-13，P
Background N-acetylcysteine (NAC) has been shown to potentiate the effects of nitroglycerin (NTG) and to have antioxidant activity. This is the first study to assess the safety and effect of NAC in the treatment of evolving acute myocardial infarction (AMI).Methods and Results Patients with AMI received either 15 g NAC infused over 24 hours (n=20) or no NAC (n=7), combined with intravenous NTG and streptokinase. Peripheral venous plasma malondialdehyde (MDA), reduced (GSH) and oxidized (GSSG) glutathione concentrations, and rate of reperfusion (using continuous ST-segment analysis) were measured. Cardiac catheterization was performed between days 2 and 5. No significant adverse events occurred. Less oxidative stress occurred in patients treated with NAC than in patients not receiving NAC (GSH to GSSG ratio 44+/-25 versus 19+/-13 at 4 hours, P